Topic Contents

Head Injury, Age 3 and Younger

Topic Overview

Head injury

Almost all children will bump their heads, especially when they are
babies or toddlers and are just learning to roll over, crawl, or walk. These
accidents may upset you, but your anxiety is usually worse than the injury.
Most head injuries in children are minor.

Head injury occurs more
often in young children than adults. When compared with adults:

Young children can't control the movement of
their heads as well as adults.

Their heads are larger in relation to their
bodies.

Their neck muscles are not as well developed.

Young children's legs are somewhat shorter in
proportion to the rest of their bodies. This makes a child's center of gravity
closer to the head than an adult's center of gravity.

Young
children are more likely to have an accident or fall as they learn new skills
such as walking, running, and jumping.

Bumps, cuts, and scrapes on the head and face usually heal
well and can be treated the same as injuries to other parts of the body. A
superficial cut on the head often bleeds heavily because the face and scalp
have many blood vessels close to the surface of the skin. This bleeding is
alarming, but often the injury is not severe and you can stop the bleeding with
home treatment. When bleeding does not stop with home treatment, visit
a doctor because a young child can lose a large amount of blood from a deep cut
on the head.

The most common serious head injuries in young
children are caused by falls and abuse (inflicted head injuries), such as shaken baby syndrome. Serious head
injuries may involve injuries to the brain. The more force that is involved in
a head injury, the more likely it is that a serious injury to the brain has
occurred. If there has been a
high-energy injury to the head, there is a greater
likelihood that a serious injury has occurred. When a high-energy injury
occurs, it is even more important to assess the child for
signs of a serious head injury.

Following an injury, it can be hard to tell the difference between a
mild traumatic brain injury (concussion) and a more serious brain
injury. Watch the child carefully for 24 hours after a head injury to see
whether he or she develops any signs of a serious head injury.

When a head injury has occurred, look for injuries to other parts of the
body. The alarm of seeing a head injury may cause you to overlook other
injuries that need attention. Trouble breathing, shock, spinal injuries, and severe bleeding are all life-threatening injuries that may occur along with a
head injury and require immediate medical attention.
Injuries to the spine, especially the neck, must be
considered when a head injury has occurred. Be sure to check for other injuries to the face, mouth, or teeth whenever there is a head injury.

Many head injuries can
be prevented. Use car seats, seat belts, helmets, and
make your home safe from falls to prevent an injury. Establish good safety
habits early so your child will continue them when he or she is older.

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

Your age. Babies and older
adults tend to get sicker quicker.

Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.

Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.

Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.

Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.

Call 911 Now

Based on your answers, you need
emergency care.

Call911or other emergency services now.

Call 911 Now

Based on your answers, you need
emergency care.

Call911or other emergency services now.

Do not move the person unless there is an immediate threat to the person's life, such as
a fire. If you have to move the person, keep the head and neck supported and in
a straight line at all times. If the person has had a diving accident and is
still in the water, float the person face up in the water.

Call 911 Now

Based on your answers, you need
emergency care.

Call911or other emergency services now.

Put direct, steady pressure on the
wound until help arrives. Keep the area raised if you can.

Seek Care Today

Based on your answers, you may need care soon. The
problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms
and arrange for care.

If you cannot reach your doctor or you don't
have one, seek care today.

Babies' heads are easily damaged, and their neck muscles are
not strong enough to control the movement of the head. Shaking or throwing a baby can cause the head to jerk back and forth. This can
make the skull hit the brain with force, causing brain damage, serious vision
problems, or even death.

Symptoms of a skull fracture may
include:

Clear or bloody fluid draining from the ears or
nose.

Bruising under the eyes or behind the
ears.

Drooping of the face.

A dent anywhere on the head.

With severe bleeding, any of these may
be true:

Blood is pumping from the wound.

The
bleeding does not stop or slow down with pressure.

Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may
be true:

The bleeding slows or stops with pressure but
starts again if you remove the pressure.

The blood may soak through
a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be
true:

The bleeding stops on its own or with
pressure.

The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Other symptoms related to a head injury that may appear later include:

Repeated episodes of feeling dizzy or
lightheaded.

Changes in mood or personality. For a baby or toddler,
you may notice this as the child being a lot fussier than
normal.

Changes in the ability to concentrate and listen.

Ringing in the ears.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

Head Injury, Age 4 and Older

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

Try home treatment to relieve the
symptoms.

Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.

Home Treatment

First aid for a head injury

Parents should watch their child for any problems after the injury. Home treatment can
help relieve swelling and bruising of the skin or scalp and pain that occurs
with a minor head injury.

If your child had an accident, try to remain
calm and speak to your child in a calm, relaxed voice. This will help reduce
your child's fear and allow you to assess the situation.

To stop any bleeding, apply firm pressure directly over the cut
with a clean cloth or bandage for 15 minutes. If the cut is deep and may have penetrated the skull,
emergency treatment is needed.

Check for injuries to other parts of
the body, especially if the child has fallen. The alarm from seeing a head
injury may cause you to overlook other injuries that need
attention.

Apply
ice or cold packs to reduce the swelling if your child will let you hold a cold pack on the injury. A "goose egg" lump may appear
anyway, but ice will help ease the pain. Always keep a cloth between your
child's skin and the ice pack. Do not apply ice for longer than 15 to 20
minutes at a time, and do not let your child fall asleep with the ice on his or
her skin.

If your child is seen by a doctor

Be sure to follow
the instructions given to you by your child's doctor. He or she will tell you what problems to look for and how closely to watch your child for the next 24 hours or longer.

Do not give any medicine, including
nonprescription
acetaminophen, such as Tylenol, to a child
you are watching for signs of a more serious head injury unless your doctor
tells you to.

Prevention

Prevent head injuries

Each new learning stage for your baby
requires increased attention on your part to prevent an injury. It may surprise
you how fast your baby can move from one stage to the next. Being aware of your
baby's abilities and what skills he or she is likely to develop next will help
you prevent injuries. A nursery equipment safety checklist will help you keep your baby's environment safe.

Always be gentle with your baby. Be sure to protect your baby from a brain injury.
Shaking or slapping a baby in anger can cause an
injury to the brain. If a baby has been shaken or slapped, it is your
responsibility to notify your doctor.

Be aware of your baby's risk
of falling. Watch your baby carefully.

Never leave your baby alone in high places, such
as on a tabletop, in a crib with the sides down, or even on a bed or
sofa.

Do not leave your baby alone in any infant seat or "sitting"
toy, such as a swing or jumper. Use all the safety straps provided.

Take steps to prevent falls:

Use
stair gates to block stairways. Use gates at the top
and bottom of the stairs, and use the gates properly.

Do not use
baby walkers. Walkers have caused many injuries and are not safe even if the
baby is watched closely.

Keep your baby away from elevated porches,
decks, and landings.

Watch your toddler when he or she is outside.
Uneven grass, sloping lawns, and hills may increase your toddler's risk of
falling.

Practice good safety habits early so your child will continue
them when he or she is older:

Place children in an approved
child car seat when traveling in a motor vehicle.
Follow the manufacturer's directions for installing and securing the
seat.

Have your children wear helmets whenever necessary, such as
when they are passengers on a bike or riding a tricycle on their
own.

Set a good example by always using your seat belt when
traveling in a motor vehicle. Wear a helmet and other protective clothing
whenever you are biking, skateboarding, skiing, motorcycling, skating,
kayaking, horseback riding, or rock climbing.

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How this information was developed to help you make better health decisions.